BILL NUMBER: SB 718AMENDED BILL TEXT AMENDED IN ASSEMBLY SEPTEMBER 3, 2013 AMENDED IN ASSEMBLY JUNE 20, 2013 AMENDED IN SENATE MAY 15, 2013 AMENDED IN SENATE APRIL 4, 2013 INTRODUCED BY Senator Yee FEBRUARY 22, 2013 An act to add Section 6401.8 to the Labor Code, relating to employment safety. LEGISLATIVE COUNSEL'S DIGEST SB 718, as amended, Yee. Hospitals: workplace violence preventionplan.plan. Existing law regulates the operation of health facilities, including hospitals. Existing law, the California Occupational Safety and Health Act of 1973, imposes safety responsibilities on employers and employees, including the requirement that an employer establish, implement, and maintain an effective injury prevention program, and makes specified violation of these provisions a crime. Thisbill would require a hospital, as specified, as a part of its injury prevention program and in conjunction with affected employees, to adopt a workplace violence prevention plan designed to protect health care workers, other facility personnel, patients, and visitors from aggressive or violent behavior. As part of that plan, the bill would require a hospital to adopt safety and security policies, including, among others, a system for the reporting to the Division of Occupational Safety and Health of any violent incident, as defined, against a hospital employee, as specified. The bill would further require all medical staff and health care workers who provide direct care to patients to receive, at least annually, workplace violence prevention education and training, as specified. Thebill would prohibit a hospital , as specified, from preventing an employee from, or taking punitive or retaliatory action against an employee for, seeking assistance and intervention from local emergency services or law enforcement for a violent incident. The bill would also require a hospital to provide evaluation and treatment, as specified, for an employee who is injured or is otherwise a victim of a violent incident. The bill would require a hospital to document and keep for 5 years a written record of all violent incidents against a hospital employee, as defined, and to report to the division any violent incident, as specified. The bill would also authorize the division to assess a civil penalty against a hospital for failure to report a violent incident, as specified. The bill would further require the division to post on its Internet Web site a report regarding violent incidents at hospitals, as specified, and to adopt regulations implementing these provisions by January 1, 2015. Because this bill would expand the scope of a crime, the bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason. Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. Section 6401.8 is added to the Labor Code, to read:6401.8. (a) Except as provided in subdivision (n), as a part of its injury prevention program required pursuant to Section 6401.7, a hospital described in subdivision (a), (b), or (f) of Section 1250 of the Health and Safety Code shall adopt a workplace violence prevention plan designed to protect health care workers, other facility personnel, patients, and visitors from aggressive or violent behavior. The plan shall include, but not be limited to, security considerations relating to all of the following: (1) Physical layout. (2) Staffing, including staffing patterns and patient classification systems that contribute to the risk of violence or are insufficient to address the risk of violence. (3) The adequacy of facility security systems, protocols, and policies, including, but not limited to, security personnel availability and employee alarm systems. (4) Potential security risks associated with specific units or areas within the facility where there is a greater likelihood that a patient or other person may exhibit violent behavior. (5) Uncontrolled public access to any part of the facility. (6) Potential security risks related to working late night or early morning hours. (7) Employee security in areas surrounding the facility, including, but not limited to, employee parking areas. (8) The use of a trained response team that can assist employees in violent situations. (9) Policy and training related to appropriate responses to violent acts. (10) Efforts to cooperate with local law enforcement regarding violent acts in the facility. (b) As part of its workplace violence prevention plan, a hospital shall adopt safety and security policies, including, but not limited to, all of the following: (1) Personnel training policies designed to protect personnel, patients, and visitors from aggressive or violent behavior, including education on how to recognize the potential for violence, how and when to seek assistance to prevent or respond to violence, and how to report violent incidents to the appropriate law enforcement officials. (2) A system for responding to violent incidents and situations involving violence or the risk of violence, including, but not limited to, procedures for rapid response by which an employee is provided with immediate assistance if the threat of violence against that employee appears to be imminent, or if a violent act has occurred or is occurring. (3) A system for investigating violent incidents and situations involving violence or the risk of violence. When investigating these incidents, the hospital shall interview any employee involved in the incident or situation. (4) A system for reporting, monitoring, and recordkeeping of violent incidents and situations involving the risk of violence. (5) A system for reporting violent incidents to the division pursuant to subdivision (h). (6) Modifications to job design, staffing, security, equipment, or facilities as determined necessary to prevent or address violence against hospital employees. (c) The plan shall be developed in conjunction with affected employees, including their recognized collective bargaining agents, if any. Individuals or members of a hospital committee responsible for developing the security plan shall be familiar with hospital safety and security issues, as well as the identification of aggressive and violent predicting factors. In developing the workplace violence prevention plan, the hospital shall consider guidelines or standards on violence in health care facilities issued by the division, the federal Occupational Safety and Health Administration, and, if available, the State Department of Public Health. (d) All medical staff and health care workers who provide direct care to patients shall, at least annually, receive workplace violence prevention education and training that is designed in such a way as to provide an opportunity for interactive questions and answers with a person knowledgeable about the workplace violence prevention plan, and that includes, but is not limited to, the following topics: (1) General safety measures. (2) Personal safety measures. (3) The assault cycle. (4) Aggression and violence predicting factors. (5) Obtaining patient history from a patient with violent behavior. (6) Characteristics of aggressive and violent patients and victims. (7) Verbal and physical maneuvers to diffuse and avoid violent behavior. (8) Strategies to avoid physical harm. (9) Restraining techniques. (10) Appropriate use of medications as chemical restraints. (11) Any resources available to employees for coping with violent incidents, including, by way of example, critical incident stress debriefing or employee assistance programs. (e) All temporary personnel shall be oriented to the workplace violence prevention plan. (f) A hospital shall provide evaluation and treatment for an employee who is injured or is otherwise a victim of a violent incident and shall, upon the request of the employee, provide access to followup counseling to address trauma or distress experienced by the employee, including, but not limited to, individual crisis counseling, support group counseling, peer assistance, and professional referrals. (g)6401.8. (a) A hospital described in subdivision (a), (b), or (f) of Section 1250 of the Health and Safety Code shall not prohibit an employee from, or take punitive or retaliatory action against an employee for, seeking assistance and intervention from local emergency services or law enforcement when a violent incident occurs.(h)(b) (1) In addition to the reports required by Section 6409.1, a hospital shall document and keep for a period of five years a written record of any violent incident against a hospital employee immediately after the incident is reported by that employee or any other employee to a manager, supervisor, or other hospital administrator. The hospital shall document and keep a written record of all violent incidents, regardless of whether the employee sustains an injury. This record shall include, but not be limited to, the date and time of the incident, the unit in which the incident occurred, a description of the circumstances surrounding the incident, and the hospital's response to the incident. (2) A hospital shall report to the division within 72 hours the information recorded pursuant to paragraph (1) regarding a violent incident. If the incident results in physical injury, involves the use of a firearm or other dangerous weapon, or presents an urgent or emergent threat to the welfare, health, or safety of hospital personnel, the hospital shall report the incident to the division within 24 hours. (3) If a hospital fails to report a violent incident pursuant to paragraph (2), the division may assess a civil penalty against the hospital in an amount not to exceed one hundred dollars ($100) per day for each day that the incident is not reported following the initial 72-hour or 24-hour period, as applicable pursuant to paragraph (2).(i)(c) The division may, at its discretion, conduct an inspection for any violent incident reported pursuant to subdivision(h)(b) .(j)(d) Nothing in this section requiring recordkeeping and reporting by an employer relieves the employer of the requirements of Section 6410.(k)(e) By January 1, 2015, and annually thereafter, the division shall, in a manner that protects patient and employee confidentiality, post a report on its Internet Web site containing information regarding violent incidents at hospitals, that includes, but is not limited to, the total number of reports and which specific hospitals filed reports pursuant to subdivision(h),(b), the outcome of any related inspection or investigation, citations levied against a hospital based on a violent incident, and recommendations on how to prevent violent incidents at hospitals.( l) (f) By January 1, 2015, the division shall adopt regulations to implement the provisions of this section.(m)(g) For purposes of this section, "violent incident" shall include, but not be limited to, the following: (1) The use of physical force against a hospital employee by a patient or a person accompanying a patient that results in or has a high likelihood of resulting in injury, psychological trauma, or stress, regardless of whether the employee sustains an injury. (2) An incident involving the use of a firearm or other dangerous weapon, regardless of whether the employee sustains an injury.(n)(h) This section shall not apply to a hospital operated by the State Department of State Hospitals, the State Department of Developmental Services, or the Department of Corrections and Rehabilitation. SEC. 2. No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.